Original article
Outcomes of a Weight-Bearing Rehabilitation Program for Patients Diagnosed With Patellofemoral Pain Syndrome

Presented in part to the National Athletic Trainers’ Symposium, June 2005, Indianapolis, IN.
https://doi.org/10.1016/j.apmr.2006.07.264Get rights and content

Abstract

Boling MC, Bolgla LA, Mattacola CG, Uhl TL, Hosey RG. Outcomes of a weight-bearing rehabilitation program for patients diagnosed with patellofemoral pain syndrome.

Objective

To determine the effects of a weight-bearing rehabilitation program on quadriceps and gluteus medius electromyographic activity, pain, and function in subjects diagnosed with patellofemoral pain syndrome (PFPS).

Design

Pretest and posttest 6-week intervention study.

Setting

Musculoskeletal research laboratory.

Participants

Fourteen subjects diagnosed with PFPS and 14 healthy control subjects volunteered to participate in this study. No subjects withdrew from the study because of adverse effects.

Intervention

Subjects diagnosed with PFPS participated in a 6-week rehabilitation program. The rehabilitation program consisted of weight-bearing exercises that focused on strengthening the quadriceps and hip abductor musculature.

Main Outcome Measures

Electromyographic onsets of the vastus medialis oblique (VMO) and vastus lateralis and onset and duration of the gluteus medius were collected during a stair-stepping task that was performed during the pretest and posttest. A visual analog scale (VAS) and Functional Index Questionnaire (FIQ) were administered at pretest and posttest and each week of the intervention.

Results

Vastus lateralis and VMO onset timing differences (vastus lateralis electromyographic onset minus VMO electromyographic onset) and VAS and FIQ scores significantly improved for patients diagnosed with PFPS. Vastus lateralis and VMO onset timing in the PFPS group were significantly different from those in the control group at baseline and were not significantly different from the control group after the intervention. We did not find differences in gluteus medius onsets or duration of activity.

Conclusions

Subjects diagnosed with PFPS responded favorably and quickly to a therapeutic exercise program that incorporated quadriceps and hip musculature strengthening. The efficacy of the therapeutic exercise program used in this study should be further investigated in a larger subject population.

Section snippets

Participants

Twenty-eight subjects (14 controls, 14 experimental) between the ages of 18 and 42 years were recruited. For the experimental group, we recruited 5 men and 9 women (age, 24±6y; height, 167.5±10.1cm; weight, 71.6±12.2kg; duration of symptoms, 22±25mo) from the University of Kentucky Clinic and general campus population. Inclusion criteria were (1) anterior or retropatellar knee pain reported during at least 2 of the following activities: ascending and descending stairs, hopping and running,

Results

Means and SDs for each electromyographic variable are presented in table 1.

Discussion

The results of this study indicate that subjects with PFPS had decreased pain, increased function, and altered vastus lateralis and VMO onset timing differences after the weight-bearing rehabilitation program. These results are similar to those reported by Cowan et al9 after a McConnell-based rehabilitation program.

This investigation differed from a few of the previous investigations because there was no focus on specific VMO activation.9, 23, 24, 25, 26, 27, 28 This program integrated balance,

Conclusions

Our investigation has provided evidence that the vastus lateralis and VMO onset timing difference may change after a weight-bearing rehabilitation program. This investigation also showed the effectiveness of a supervised home rehabilitation program to decrease pain and increase function in subjects diagnosed with PFPS. Future research should investigate the different components of a rehabilitation program (quadriceps strengthening, gluteus medius strengthening, lower-extremity neuromuscular

Acknowledgments

We thank the National Athletic Trainers’ Association for funding this investigation. We also thank Alcan Airex for the donation of Airex balance pads used by subjects with PFPS for the rehabilitation program.

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    Funded by National Athletic Trainers’ Association (Osternig Masters grant).

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

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